Texas 2009 - 81st Regular

Texas Senate Bill SB1978 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	2009S0658-1 03/10/09
2	2	By: Carona S.B. No. 1978
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to requirements regarding employer liability for certain
8	8	group health benefit plan premiums.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 843.210, Insurance Code, is amended to
11	11	read as follows:
12	12	Sec. 843.210. TERMS OF ENROLLEE ELIGIBILITY. (a) A
13	13	contract between a health maintenance organization and a group
14	14	contract holder must provide that:
15	15	(1) in addition to any other premiums for which the
16	16	group contract holder is liable, the group contract holder is
17	17	liable for an enrollee's premiums from the time the enrollee is no
18	18	longer part of the group eligible for coverage under the contract
19	19	until the end of the month in which the contract holder notifies the
20	20	health maintenance organization that the enrollee is no longer part
21	21	of the group eligible for coverage by the contract; and
22	22	(2) the enrollee remains covered by the contract until
23	23	the end of that period.
24	24	(b) A health maintenance organization shall refund premiums
25	25	paid by a group contract holder on behalf of an enrollee, from the
26	26	end of the month during which the enrollee is no longer part of the
27	27	group eligible for coverage, provided that the enrollee did not
28	28	incur any claims under the contract after no longer being part of
29	29	the group eligible for coverage.
30	30	(c) The commissioner shall adopt rules as necessary to
31	31	implement this section.
32	32	SECTION 2. Section 1301.0061, Insurance Code, is amended to
33	33	read as follows:
34	34	Sec. 1301.0061. TERMS OF ENROLLEE ELIGIBILITY. (a) A
35	35	contract between an insurer and a group policyholder under a
36	36	preferred provider benefit plan must provide that:
37	37	(1) in addition to any other premiums for which the
38	38	group policyholder is liable, the group policyholder is liable for
39	39	an individual insured's premiums from the time the individual is no
40	40	longer part of the group eligible for coverage under the policy
41	41	until the end of the month in which the policyholder notifies the
42	42	insurer that the individual is no longer part of the group eligible
43	43	for coverage under the policy; and
44	44	(2) the individual remains covered under the policy
45	45	until the end of that period.
46	46	(b) An insurer shall refund premiums paid by a group
47	47	policyholder on behalf of an individual, from the end of the month
48	48	during which the individual is no longer part of the group eligible
49	49	for coverage, provided that the individual did not incur any claims
50	50	under the policy after no longer being part of the group eligible
51	51	for coverage.
52	52	(c) The commissioner shall adopt rules as necessary to
53	53	implement this section.
54	54	SECTION 3. The change in law made by this Act applies only
55	55	to a contract between an insurer or health maintenance organization
56	56	and a group policy or contract holder that is entered into or
57	57	renewed on or after January 1, 2010. A contract entered into or
58	58	renewed before January 1, 2010, is governed by the law in effect
59	59	immediately before the effective date of this Act, and that law is
60	60	continued in effect for that purpose.
61	61	SECTION 4. This Act takes effect September 1, 2009.